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Agency for Healthcare Research & Quality Centers of Excellence

Examining health systems in five regions to understand the role of incentives, use of health IT and organizational integration within systems and its impact on performance and evidence dissemination.

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This effort is part of AHRQ's ongoing work to accelerate the dissemination and implementation of patient-centered outcomes research, or PCOR, findings into practice. The three Centers of Excellence will identify, classify, track and compare health care delivery systems to understand the organizational and environmental factors affecting the use of evidence-based medicine.

The RAND Center of Excellence will examine health systems in five regions with the goal of understanding the role of incentives, use of health IT and organizational integration within systems and its impact on performance and evidence dissemination.

PI:  Dennis Scanlon

Can Risk-Adjusted Emergency Department Utilization Measure Quality or Value in Cancer Care?

Evaluating whether oncology patients’ risk-adjusted ED rates can be used as a hospital-level measure of quality and value of care.

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As the costs of treating cancer continue to soar, several organizations have produced value frameworks to identify and highlight high value treatments that provide a favorable balance of quality and cost. However, few include hospital-based outcomes measures other than survival. This study evaluates  whether oncology patients’ risk-adjusted ED rates can be used as a hospital-level measure of quality and value of care.

PI:  Joel Segel

Continuous Quality Improvement of the Pennsylvania Coordinated Medication Assisted Treatment (PacMAT)

Facilitation of technical assistance, including identifying facilitators and barriers to success, and lessons learned; spillover effects on local community outcomes; as well as site sustainability mapping and planning of the PA Coordinated Medication Assisted Treatment (PacMAT).

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This project is organized around the following domains: support around understanding PacMAT service provision outcomes; changes in site capacity due to PacMAT; patient relapse; morbidity and mortality outcomes; patient service utilization and claims (cost) outcomes; a qualitative analysis to understand implementation of the PacMAT program including variation across sites in order to provide feedback to site operators; and providing medication assisted treatment (MAT) focused continuing medical education credits to practitioners, furthering statewide reach.

PI:  Joel Segel & Max Crowley

Diabetes Prevention Program (DPP)

This project, based on the CDC’s national DPP, involves planning and implementing an evidence-based lifestyle intervention to prevent Type 2 diabetes in the State College area

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The year-long intervention involves 16 weekly classes over the course of the first 6 months followed by monthly classes for the remaining 6 months on topics related to diet, exercise, and maintaining a healthy lifestyle. The intervention will be conducted by Penn State Health practitioners in conjunction with researchers from the University and members of the Penn State Office of Human Resources. In addition, Penn State researchers led by a team from HPA and CHCPR will conduct an evaluation to understand the program’s effect on weight loss, blood pressure, glycemic levels, and other relevant clinical outcomes. A known limitation of the national DPP relates to enrollment and retention challenges. To better understand how to improve retention and achievement of DPP clinical goals, the study will also involve a randomized controlled trial where cohorts will be randomized to treatment arms that will include motivational messaging and varying types of financial incentives to incorporate important concepts from the behavioral economics and health communication literature.

PI:  Dennis Scanlon

Disparities in the Quality of Inter-Hospital Transfers

This study aims to develop capacity and infrastructure for the Penn State CTSI Regulatory Impact, Regulatory and Ethics Core, including developing community engagement opportunities with Government Health Relations.

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Evidence-based policies such as transfer guidelines for hospitalized patients have the potential to impact public health, but only to the extent that they are actually used.  Laws are an important mediator of the relationship between the research that creates the guidelines and their public health impact, as they influence what providers do and thus what care patients receive .  However, there is currently insufficient research on the extent to which laws actually affect provider behavior. 

PI:  Charleen Hsuan

Estimation of Societal Costs to States Due to Opioid Epidemic

Sponsored by the Pennsylvania Office of Attorney General, this project investigates opioid manufacturer and distributor behavior in influencing the opioid epidemic and to estimates the societal costs borne by states as a result of the epidemic.

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The Penn State team produced a report structured around an overall framework showing the conceptual linkages between alleged behaviors undertaken by opioid manufacturing and distributing companies that may have contributed to the opioid epidemic and the resulting costs borne by states. The team examined the scope of damages from five areas of concern:

1) Health Care Utilization costs

2) Child Welfare and Youth Services costs

3) Criminal Justice costs

4) Education and Special Education costs

5) Employment and Disability costs

PI:  Dennis Scanlon

Evaluation of the Pennsylvania Rural Health Model 

An independent evaluation of the Pennsylvania Rural Health Model  being conducted by the Center for Medicare and Medicaid Innovation, within the Centers for Medicare and Medicaid Services.

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The PA Rural Health Model was established under the authority of  the Social Security Act, which authorizes CMS to design, test, and evaluate innovative payment and service delivery Models that have the potential to reduce Medicare and Medicaid spending while preserving or improving the quality of care received by beneficiaries. This study is an evaluation of the Rural Health Model.

PI:  Dennis Scanlon

Pennsylvania Rural Health Model

Designed in partnership with the Center for Medicare and Medicaid Innovation (CMMI), the Pennsylvania Rural Health Model is an alternative payment model designed to address the financial challenges faced by rural hospitals by transitioning them from fee-for-service to global budget payments.

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The Pennsylvania Rural Health Model aligns incentives for providers to deliver value-based care and provides an opportunity for rural hospitals to transform the care they deliver to better meet community health needs by improving population health outcomes and quality of care while lowering costs.

CHCPR will be conducting a formative evaluation of the Rural Health Model utilizing qualitative and quantitative methodology and will be providing project management leadership for the project.

PI:  Lisa Davis

Pennsylvania Sexual Assault Forensic Examination Training (SAFE-T) Center

Enhancing access to high-quality sexual assault care in underserved communities, the SAFE-T Center was launched with support from the Department of Justice, Office for Victims of Crime as a solution.

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When a sexual assault examination is performed at one of our partner hospitals, one of SAFE-T Center’s expert nurses participates through telehealth. The expert nurse appears on a screen where she can talk to, and support, both the on-site nurse and the victim. Though our specialized digital telehealth technology, she can also see the live exam in progress, ensuring best practices, proper evidence collection and a safe, helpful environment for the victim.

PI: Sheridan Miyamoto

Permanent Change of Station and Variation in Cancer Prevention and Care in the TRICARE System

This study is to use the compulsory nature of the Permanent Change of Station (PCS) to better understand if practice patterns and other supply factors can explain variations in care.

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Identifying drivers of variation in care along the breast and cervical cancer care continuum is essential to ensuring military Service members and their families receive high quality, high value care. This study particularly focuses on established, high value services such as breast and cervical cancer screening, HPV vaccination, and receipt of guideline concordant adjuvant radiation therapy following breast-conserving surgery (BCS) for breast cancer patients, which have all been shown to lead to improved health outcomes and are cost-effective. The goal of the study is to use the compulsory nature of the Permanent Change of Station (PCS) to better understand if practice patterns and other supply factors can explain variations in care. This has important implications for understanding utilization and outcome variation as well as cost implications.

PI:  Joel Segel

Use of New Hepatitis C Drugs and Patients' Health Outcomes in Medicare

Examining use of new HCV drugs and the effects of those drugs on patients’ health outcomes in Medicare.

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New drugs to treat hepatitis C virus (HCV) are innovative, but their high prices impose financial pressures on the health care system. A debate is ongoing over how to prioritize those treatments. This project examines use of new HCV drugs and the effects of those drugs on patients’ health outcomes in Medicare while providing important information needed to develop coverage decisions and policies to ensure patients’ access to needed drugs while managing spending.

PI:  Jeah Jung